Testis & paratestis
Nonneoplastic lesions
Granulomatous orchitis
Author: Sean R. Williamson, M.D.
Last author update: 1 December 2012
Last staff update: 29 December 2022
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: Granulomatous orchitis testicular
Table of Contents
Definition / general | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Williamson S. Granulomatous orchitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/testisgranulomatousorchitis.html. Accessed March 21st, 2023.
Definition / general
- Rare; usually men 40 - 59 years with sudden onset of tender testicular mass, variable fever
- May be a response to acid fast products of disintegrated sperm, postinfectious or due to trauma or sarcoidosis
- Resembles pyogenic epididymo-orchitis
- Benign, although granulomatous inflammation may be associated with seminoma
- Recommend cultures to rule out infectious process (brucellosis, leprosy, sarcoidosis, syphilis, TB)
- Granulomatous ischemic lesion:
- Usually affects head of epididymis
- May be due to ischemia with secondary granulomatous reaction and scarring
- References: (Am J Surg Pathol 1997;21:951)
Gross description
- Solid, unilateral nodular enlargement of testis; resembles lymphoma
Gross images
Microscopic (histologic) description
- Lymphocytes and plasma cells infiltrate interstitium and surround seminiferous tubules
- Giant cells and histiocytes that resemble (but are not) actual granulomas
- Granulomatous ischemic lesion:
- Zone of necrosis involving efferent ducts and interstitial connective tissue, with adjacent lymphocytes and macrophages
- Macrophages form large clusters with cholesterol crystals and foreign body type giant cells in duct lumen
- Also intratubular epithelial regeneration and proliferation of small ducts showing epithelial regeneration and numerous spermatozoa in their lumen
- Associated with ceroid granuloma, spermatic granuloma and epidermoid metaplasia of the efferent ducts
Microscopic (histologic) images
Differential diagnosis
- Granulomatous inflammation associated with seminoma
- Infection or inflammation (Hum Pathol 1990;21:1080)
- Lymphoma
